Murine Cardiac Catheterizations and Hemodynamics: On the issue of Parallel Conductance

2011 ◽  
Vol 58 (11) ◽  
pp. 3260-3268 ◽  
Author(s):  
Christakis Constantinides ◽  
Stelios I. Angeli ◽  
Richard James Mean
Keyword(s):  
Parallel Conductance ◽  
Cardiac Catheterizations

Abstract P333: A Study of Miniature Catheters' Spatial Electric Field Heterogeneity During Murine Cardiac Catheterizations

2011 ◽  
Vol 109 (suppl_1) ◽  
Author(s):  
Stelios Angeli ◽  
Richard Mean ◽  
Christakis Constantinides
Keyword(s):  
Pulse Sequence ◽  
Functional Characterization ◽  
Image Data ◽  
Geometrical Model ◽  
Input Power ◽  
Tissue Properties ◽  
Power Leakage ◽  
Parallel Conductance ◽  
Microct Imaging ◽  
Cardiac Catheterizations

Conductance catheters allow real-time quantification of hemodynamics, allowing cardiac functional characterization, an important predictor of long-term prognosis in cardiac disease. The technique’s accuracy is, however, inherently limited by the signal contribution from surrounding structures (spatially and temporally varying). Despite prior attempts to quantify this effect (known as parallel conductance) no prior study assessed the spatial heterogeneity of the catheter's E-field. This study quantifies the E-field penetration pattern, accounting for tissue properties and geometry. Ten C57BL/6J mice were induced and maintained with 1.5% isoflurane mixed in 100% O 2 . One C57BL/6J mouse underwent a right carotid catheterization for placement of a 1.4 Fr Pressure-Volume Millar catheter in the left ventricle (LV), followed by microCT imaging (80kV/160mA/10ms exposure/240 projections/rotation angle=1.5 o ). Multiphase MRI was performed using a 4D radial spiral pulse sequence (TE=300μs/TR=2.4ms/BW=125kHz/flip angle=45 o /110μm 3 resolution). Segmentation allowed LV myocardial and blood region extractions from MRI and construction of finite element End-Diastolic and End-Systolic models. The catheter’s orientation in the LV was determined from micro-CT image data renditions. Generated LV and blood models were then imported in the software XFdtd and electrical properties were assigned for all materials. Simulations used a 20 μA, 20 kHz sinusoidal current, and ran for a lump component equivalent and a constructed blood-myocardial geometrical model. Specific absorption rate (SAR) maps yielded total tissue deposited power. Simulations show that the catheter’s E-field in lump component and geometrical models, drops to 10% of its peak value at 0.4-0.6mm, and 1.1-2mm, respectively, away from the excitation electrodes. SAR maps yielded a <1% power leakage into surrounding structures at two different myocardial permittivity values of ε r =11844 and 38615. Results from this study map the spatial dependence of the generated catheter E-field. Spatial E-field maps indicate that the field is primarily confined within the ventricular chamber with a relatively uniform spatial pattern, and with <1% of the input power leaking in surrounding structures.

scholarly journals Development and validation of techniques for phenotyping ST-elevation myocardial infarction encounters from electronic health records

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Sulaiman Somani ◽  
Stephen Yoffie ◽  
Shelly Teng ◽  
Shreyas Havaldar ◽  
Girish N Nadkarni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Electronic Health Records ◽  
Hospital Admissions ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Health Records ◽  
St Elevation ◽  
Electronic Health ◽  
Cardiac Catheterizations ◽  
Discharge Summaries

Abstract Objectives Classifying hospital admissions into various acute myocardial infarction phenotypes in electronic health records (EHRs) is a challenging task with strong research implications that remains unsolved. To our knowledge, this study is the first study to design and validate phenotyping algorithms using cardiac catheterizations to identify not only patients with a ST-elevation myocardial infarction (STEMI), but the specific encounter when it occurred. Materials and Methods We design and validate multi-modal algorithms to phenotype STEMI on a multicenter EHR containing 5.1 million patients and 115 million patient encounters by using discharge summaries, diagnosis codes, electrocardiography readings, and the presence of cardiac catheterizations on the encounter. Results We demonstrate that robustly phenotyping STEMIs by selecting discharge summaries containing “STEM” has the potential to capture the most number of STEMIs (positive predictive value [PPV] = 0.36, N = 2110), but that addition of a STEMI-related International Classification of Disease (ICD) code and cardiac catheterizations to these summaries yields the highest precision (PPV = 0.94, N = 952). Discussion and Conclusion In this study, we demonstrate that the incorporation of percutaneous coronary intervention increases the PPV for detecting STEMI-related patient encounters from the EHR.

Influence of gender, race, and education on patient preferences and receipt of cardiac catheterizations among coronary care unit patients

1996 ◽  
Vol 78 (9) ◽  
pp. 996-1001 ◽  
Author(s):  
Alison D. Schecter ◽  
Pascal J. Goldschmidt-Clermont ◽  
Glenda McKee ◽  
Donna Hoffeld ◽  
Mary Myers ◽  
...  
Keyword(s):  
Patient Preferences ◽  
Coronary Care Unit ◽  
Race And Education ◽  
Coronary Care ◽  
Cardiac Catheterizations

EARLY MANIFESTATIONS OF THE CARDIOVASCULAR DISORDERS IN MARFAN SYNDROME

PEDIATRICS ◽  
1961 ◽  
Vol 27 (2) ◽  
pp. 255-268
Author(s):  
A. C. Papaioannou ◽  
M. H. Agustsson ◽  
B. M. Gasul
Keyword(s):  
Marfan Syndrome ◽  
Venous Return ◽  
Heart Defects ◽  
Main Pulmonary Artery ◽  
Clinical Findings ◽  
Early Age ◽  
Cardiac Lesions ◽  
Laboratory Procedures ◽  
General Aspects ◽  
Cardiac Catheterizations

We have studied four children varying in age from 5 months to 26 months with typical features of Marfan syndrome. Aside from the routine clinical and laboratory procedures, phonocardiograms, cardiac catheterizations, angiocardiograms and retrograde aortograms were performed. All patients had demonstrable aneurysms of the aortic sinuses of Valsalva and dilatation of the ascending aorta and of the main pulmonary artery. One case had a partial anomalous venous return to the innominate vein. The phonocardiograms demonstrated accentuated pulmonic closures, mid or late systolic murmurs and in one case an apical pansystolic murmur. The anomalies found at necropsy in one infant at the age of 12 days and other congenital heart defects in three older patients are reported. The general aspects of the disease are discussed and a review of the associated cardiac lesions in previously reported cases is presented. Attention is called to the minimal clinical findings of serious underlying cardiac lesions at a very early age, which can only be demonstrated by angiocardiography and retrograde aortography. To our knowledge these are the youngest patients in whom these cardiovascular lesions were demonstrated during life.

Abstract 322: Optimizing Cardiac Catheterization Laboratory Utilization

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
William E Lawson ◽  
Lisa Wilbert ◽  
Lisa Sokoloff ◽  
Allen Jeremias ◽  
Anil Mani
Keyword(s):  
Length Of Stay ◽  
Limited Resource ◽  
Median Number ◽  
Skewed Distribution ◽  
Median Length ◽  
Case Volume ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Cardiac Catheterizations ◽  
Effective Use

Background: Optimizing efficient utilization of the catheterization lab is an important concern. Inefficient use of this limited resource increases costs and can compromise patient care. At times of high hospital and specialty care unit census, cath lab throughput is also limited by the availability of recovery beds which may further compromise efficient throughput. At SBUH the cardiac cath lab is staffed from 0630-2300 daily Monday-Friday with an on-call team to provide 7 x 24 hour coverage for STEMI’s. Lab usage was evaluated to determine if this was an efficient and effective use of this limited resource. Methods: All cardiac catheterizations during the period of 10/1/12-12/31/12 were reviewed. The distribution of daily cases, mean and median hours to catheterization by day of the week and median length of stay (ALOS) were determined. Elective outpatient, inpatient, and emergent cases were included. Results: There were a total of 997 cases during this quarter. Average weekday case volume ranged from 13-17 cases/day with the greatest average number of cases performed on Mondays (24% of the weeks cases). Median hours to the cath lab averaged 4.2 hours with the greatest delay on Mondays (5.4 hrs) and Fridays (5.7 hrs). The median number of hours to the cath lab was 31.3 hours with the greatest delay on Fridays (38.5 hrs) and gradually decreasing times from Monday through Thursday with the lowest time delay being on Thursdays (18.9 hrs). The median length of stay averaged 1.11 days, with Mondays patients averaging the longest stays at 1.26 days. There were 45 emergent STEMI cases (5% of the total) during the reviewed period. Conclusions: The marked disparity in mean and median hours reflects a skewed distribution, with many inpatients delayed in going to the CCL. Both median and mean hours were prolonged on Mondays and Fridays along with median length of stay. Further drill down suggested hand-offs, inter-hospital transfer delays, high bed occupancy, and high patient volume contributed to delays on these days. Operator availability, procedure variance, and case mix also contributed to distortions in scheduling and the effective use of lab time. Mid week, Wednesday, was the most efficient day. Block scheduling has since been implemented to better accomodate operators and procedure types within the current staffing constraints. Also as a result of this analysis fewer outpatients are being scheduled on Mondays, changes have been made in ACS protocols, hand-offs, rounding and transfers, and opening the cath lab on a weekend day for inpatients is planned.

Cancer Mortality Following Cardiac Catheterization: A Preliminary Follow-up Study on 4,891 Irradiated Children

PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 235-239
Author(s):  
Robert F. Spengler ◽  
David H. Cook ◽  
E. Aileen Clarke ◽  
Peter M. Olley ◽  
Alice M. Newman
Keyword(s):  
Cardiac Catheterization ◽  
Cancer Mortality ◽  
Wilms Tumor ◽  
Cancer Death ◽  
Radiation Induced Cancer ◽  
Radiation Induced ◽  
System Tumor ◽  
Sick Children ◽  
Cardiac Catheterizations

A retrospective cohort study was conducted on the risk of radiation-induced cancer mortality following cardiac catheterization. The study included 4,891 children with congenital heart disease who were assessed by cardiac catheterization during 1946 to 1968 at The Hospital for Sick Children, Toronto. The cohort was matched against the Ontario cancer death file from 1950 to 1975. The average period of follow-up was 13 years and more than 66,000 person-years have been accrued from the cohort. No deaths from breast cancer or thyroid cancer were identified. Five cancer deaths were observed and compared with 4.8 expected deaths based on Ontario cancer death rates. The five cancer deaths resulted from three leukemias, one Wilms' tumor, and one unspecified nervous system tumor. The preliminary findings did not demonstrate a significant leukemia risk arising from diagnostic cardiac catheterizations. Continued follow-up of this cohort is required to evaluate the risk of breast and thyroid cancers which can occur more than 20 years following radiation exposure.

Elongated Patent Ductus Arteriosus with Intermittent Shunting

PEDIATRICS ◽  
1967 ◽  
Vol 39 (3) ◽  
pp. 446-448
Author(s):  
COLETTE M. KOHLER ◽  
DAN G. MCNAMARA
Keyword(s):  
Pulmonary Hypertension ◽  
Case Report ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Cardiac Defects ◽  
Cardiac Catheterizations ◽  
Delayed Closure ◽  
Patent Ductus

The presence of patent ductus arteriosus without a typical continuous murmur has long been recognized, especially in the presence of pulmonary hypertension, or a small ductus, or with associated cardiac defects; however, there are only a few reports of documented, intermittently disappearing murmurs occurring in individuals over 6 months of age with a substantial shunt in the absence of pulmonary hypertension or associated defects. Danilowicz, et al. have recently reported delayed closure of the ductus anteriosus up to 6 months of age in some premature infants. We present this case report of a 2½-year-old boy with patent ductus arteriosus with cardiac catheterizations during the disappearance and subsequent reappearance of a continuous murmur with documentation of absence of shunting when the murmur was absent and substantial shunting if the murmur was present.

Radiogenic risks to patients and staff from fluoro-assisted therapeutic cardiac catheterizations

2020 ◽  
Vol 167 ◽  
pp. 108348 ◽  
Author(s):  
A. Sulieman ◽  
A. Abdelrazig ◽  
H. Al-Mohammed ◽  
M. Alkhorayef ◽  
B. Alonazi ◽  
...  
Keyword(s):  
Cardiac Catheterizations
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